Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.pdf
PDF 150 KB Posted
- Attached to
- Wood Poles
- Solicitation number
- RFB 605 2300000526 1
- Issued by
- Elliott County, Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky, effective under Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit is valid for one year from the date of execution and must be submitted by any bidder, offeror, or contractor seeking to be awarded a contract or secure contract renewal from the state. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed affidavit to the Commonwealth. The affidavit serves as a prerequisite for contract award and renewal eligibility.
The affidavit requires the authorized representative to attest under penalty of perjury that the contractor has not knowingly violated Kentucky's campaign finance laws and that contract award will not violate any provision of such laws. For purposes of this attestation, "knowingly" is defined as awareness or reasonable awareness of a violation's existence. The Commonwealth retains the right to request an updated affidavit at any time during the contract period. The form requires the contractor's name, address, Commonwealth vendor code if applicable, the authorized representative's signature, printed name, title, and date, along with notarization information including the notary's signature, commission expiration date, and the state and county of notarization.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_605_2300000526_1_SO_FORM.PDF | ||
| How to Respond to Online Bid through Kentucky Vendor Self....pdf |
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Text version
Rev. 9-16-22 Required Affidavit for Bidders, Offerors and Contractors
(KRS 45A.110 & 45A.115)
Affidavit Effective for One (1) Year from Date of Execution
Instructions: Pursuant to KRS 45A.110 and 45A.115, a bidder, offeror, or contractor (“Contractor”) is required to submit a Required Affidavit for Bidders, Offerors, and Contractors to be awarded a contract, or for the renewal of a contract. An authorized representative of the contracting party must complete the attestation below, have the attestation notarized, and return the completed affidavit to the Commonwealth.
Attestation
As a duly authorized representative for the Contractor, I swear and affirm under penalty of perjury, that that the Contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that the award of a contract will not violate any provision of the campaign finance laws of the Commonwealth. For purposes of this attestation, "Knowingly" means that the bidder or offeror is aware or should have been aware of the existence of a violation. The bidder or offer understands that the Commonwealth retains the right to request an updated affidavit at any time.
Signature Printed Name
Title Date
Bidder or Offeror Name: __________________________________________________________
Address: __________________________________________________________
Commonwealth of Kentucky Vendor Code (If known): _______________
Subscribed and sworn to before me this _____ day of _______________, ____________.
State of: ___________________ Notary: ___________________________________
County of: _________________ My Commission Expires: _____________________ https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22348 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22349
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